Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dalton Andrew Wise

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1265015572

Dalton Andrew Wise is a Pathology in Torrance, California. Qualified in 2017, 9 years ago. Practices with Unm Medical Group Inc, a 1,060-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
9
Licensed in
NM
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1000 W Carson St
Torrance, CA 90502-2059
Phone: (424) 306-6219
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (NM)
Clinical Pathology/Laboratory Medicine Physician Taxonomy 207ZP0105X · Licence MD2024-1078 (NM)

Record details

NPI number1265015572
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 4, 2021
Last updated in NPPESMay 15, 2026
Certification dateMay 15, 2026
Mailing address800 Bradbury Dr Se Ste 116, Albuquerque, NM 87106-4310

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Unm Medical Group Inc — 1060 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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